Active NPI
William J McCormick, MS, PT
- Physical Therapist
- Brandon, FL
National Provider Identifier
1649270471
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT1390
- Practice address
- 1056 E Brandon Blvd
Brandon, FL 33511-5509 - Phone
- (813) 413-5513
- Fax
- (813) 681-8300
- NPI assigned
- Jul 22, 2005
- Last updated
- Apr 4, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT1390 | ME | Primary |
Addresses
Primary practice location
1056 E Brandon Blvd
Brandon, FL 33511-5509
Mailing address
3903 Northdale Blvd Ste 111W
Tampa, FL 33624-1853
Phone (813) 381-6778
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 038814 | Other | ME | BC/BS OF MAINE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1390 | ME | MD | Family Medicine Physician |
| PT1390 | ME | MD | Physical Therapist |
Networks
- Optimum HealthCare HMO Network
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121990400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1459728000000",
"number": "1649270471",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3903 NORTHDALE BLVD STE 111W",
"city": "TAMPA",
"state": "FL",
"postal_code": "336241853",
"telephone_number": "813-381-6778",
"fax_number": "440-815-2120"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1056 E BRANDON BLVD",
"city": "BRANDON",
"state": "FL",
"postal_code": "335115509",
"telephone_number": "813-413-5513",
"fax_number": "813-681-8300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCORMICK",
"first_name": "WILLIAM",
"middle_name": "J",
"credential": "MS, PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-22",
"last_updated": "2016-04-04",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "ME",
"license": "PT1390",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS OF MAINE",
"identifier": "038814",
"state": "ME"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brandon, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.